Has plain tobacco packaging failed to stop people smoking?

For more than a year, Australian tobacco smokers have been buying packs stripped of their familiar branding. A new government policy means they are confronted with a drab green pack dominated by dire health warnings and graphic images of smoking-related diseases.

''What matters is whether fewer people are smoking as a result of these policies - and the data is clear that overall tobacco consumption and smoking prevalence has not gone down,'' Chris Argent, spokesman for Philip Morris, told the Sydney Morning Herald on January 13.

ABC Fact Check investigates whether Mr Argent is correct to claim "the data is clear" that generic packaging of tobacco products has failed to reduce the number of smokers.

The claim: Philip Morris says "the data is clear" that plain packaging has not stopped people smoking.

The verdict: The data commissioned by Philip Morris is not clear, it is inconclusive. And there is contrary evidence emerging to suggest plain packaging has had an impact.

A brief history of plain packaging

In the face of significant opposition from tobacco companies and retailers, the former federal Labor government passed legislation mandating uniform plain packaging and larger health warnings for cigarettes and other tobacco products sold in Australia.

The measures came into full effect in December 2012 and included an increase in tobacco excise, restrictions on tobacco advertising online and $27.8 million in additional funding for anti-smoking campaigns.

Announcing the moves, the then health minister Nicola Roxon said: "We're targeting people who have not yet started, and that's the key to this plain packaging announcement – to make sure we make it less attractive for people to experiment with tobacco in the first place."

Ms Roxon said the government projected that the new policies would "reduce the consumption of tobacco by about 6 per cent and reduce the number of smokers by 2 to 3 per cent".

Australia is the first country to introduce plain packaging. Others including the United Kingdom are looking at similar laws.

Fact Check asked Mr Argent for the basis of his statement. Philip Morris responded with the full text of the statement he provided to the Sydney Morning Herald:

"In November 2013 a study by London Economics found that since the introduction of plain packaging in Australia there has been no change in smoking prevalence. Other research has focused on people's thoughts about quitting or intentions to quit not whether they actually will or have stopped smoking. What matters is whether fewer people are smoking as a result of these policies - and the data is clear that overall tobacco consumption and smoking prevalence has not gone down. A separate study by KPMG in the same month found that the black market in illicit tobacco in Australia is booming, costing the government up to $1 billion in forgone tax revenue. The release of the KPMG report into illicit tobacco followed the 24 October 2013 joint announcement by the Australian Federal Police, Australian Customs and Border Protection Service, Victoria Police and the Australian Crime Commission of the arrest of 10 people in relation to alleged illegal tobacco importation with around 71 tonnes and 80 million cigarette sticks seized, and an estimated total defrauded taxation revenue of this seizure alone of more than $67 million."

London Economics surveyed Australian adults three times: between July and October 2012, before the new regulations began; in March 2013, three months after their full implementation; and in July 2013. The November report was "an interim assessment" of the firm's analysis of the impact of plain packaging on smoking prevalence.

The study did not directly address the impact of plain packaging on potential new smokers, despite this being the government's stated policy priority.

It found that the largest group of tobacco consumers, those who smoke daily, fell from 20.4 per cent of the adult population before plain packs became mandatory to 19.5 per cent three months afterwards. The number of daily smokers then rose to 20 per cent in July 2013. Respondents who said they were weekly but not daily smokers initially fell, then returned to the pre-implementation level of 2.1 per cent. "Less than weekly" smoking fell from 2.3 per cent to 1.9 per cent and then rose to 2.2 per cent.

The study also found the number of people who claimed never to have smoked increased from 45.6 per cent in the second half of 2012 to 46.6 per cent in July 2013.

Those numbers represent a reduction of 0.4 per cent in the number of Australian adults smoking daily and a 1 per cent increase in the number of adults who had never smoked (suggesting more of those turning 18 do not smoke).

The report's authors said that "from a statistical perspective, none of these changes were different from zero".

They conclude that "over the timeframe of the analysis, the data does not demonstrate that there has been a change in smoking prevalence following the introduction of plain packaging and larger health warnings..."

The second report Mr Argent referred to was a study of the sale of illicit tobacco in Australia. It was conducted by accounting firm KPMG and commissioned by Imperial Tobacco, British American Tobacco and Philip Morris.

The report estimated that the overall level of tobacco consumption in Australia was 17.4 million kilograms in the year to June 2013, the same level as the year before. It said consumption of legal products fell from 15.3 million kilograms to 15.1, while consumption of illicit products increased correspondingly.

The KPMG report did not evaluate the impact of the plain packaging reforms on consumption.

Imperial Tobacco, which bills itself as the world's fourth-largest tobacco company, recently argued against the introduction of plain packaging in Britain, stating "following the introduction of standardised packaging in Australia, smoking prevalence has not been affected".

It cited the KPMG report's finding that overall consumption had remained stable. However, Imperial Tobacco's submission, dated January 10, urged the UK government to postpone deciding on plain packaging legislation because there was insufficient evidence about the impact of the Australian reforms.

It noted that the latest national statistics from Australia covering smoking prevalence were for the end of 2012 and there had been no data or anecdotal evidence on youth smoking rates in Australia after 2011.

"We are not aware of any national statistics from Australia... covering the period since standardised packaging was mandated," the submission said.

"We consider this to be an essential requirement for a proper assessment of the policy's impact."

The Australian Government was planning a review on the plain packaging measures in December 2014 "and we would expect other governments to wait until this review has been conducted before making any decisions," it said.

Other evidence

As Imperial Tobacco noted, the Australian Bureau of Statistics is yet to publish data on smoking rates since plain packaging and associated measures came into effect. In 2011-12 the ABS found 16.3 per cent of Australian adults smoked tobacco daily, down from 22.4 per cent a decade earlier. The ABS figure is significantly lower than the daily smoking rate identified by the London Economics report. The bureau's figure for adults reporting they had never smoked - 51.1 per cent - is higher.

There have been a number of recent studies into the effects of plain packaging.

A study by researchers at the University of Sydney and published in the Medical Journal of Australia this month found calls to the stop-smoking Quitline rose by 78 per cent following the appearance of plain packaging.

The authors said the study, conducted between October 2011 and April 2013, was unable to differentiate the impact of the increased size of graphic health warnings that happened simultaneously with plain packaging from the impact of plain packaging itself. However, they concluded that the increase related to the new appearance of packs and "is not attributable to anti-tobacco advertising activity, cigarette price increases nor other identifiable causes".

The study also said: "This is an important incremental step in comprehensive tobacco control".

Research led by Cancer Council Victoria's Professor Melanie Wakefield, and published in the British Medical Journal in July 2013, found plain packs reduced the appeal of smoking and increased smokers' thoughts about quitting.

Further observational research from CCV, published in the journal Addiction this month, found that smoking in outdoor areas of cafés, restaurants and bars declined following the introduction of plain packaging. The researchers also observed more smokers concealing their plain cigarette packets from view, and concluded "both are promising outcomes to minimise exposure to tobacco promotion".

What anti-smoking advocates say

Professor Mike Daube from Curtin University headed the government's Preventative Health Taskforce which recommended plain packaging for tobacco products. He says the early indications are encouraging, "especially as plain packaging was primarily aimed at preventing children from starting to smoke". And he says recent indications of an impact on adults are a very welcome bonus.

"I don't think anybody reputable would make claims about overall adult prevalence until we have the next national government-run survey," he said.

Professor Simon Chapman from the School of Public Health at the University of Sydney says he is "extremely circumspect" about any claims made by the tobacco industry, and casts doubt over the data from London Economics. "The Philip Morris claim is based on tobacco industry funded opt-in panel data which produced a 20 per cent smoking prevalence figure, compared with the government's much larger and more representative [ABS] Australian Health Survey which found 16.3 per cent daily smoking," he said.

Brief summary

The study by London Economics, commissioned by Philip Morris, found that while daily smoking rates have gone down and the number who say they have never smoked has gone up, it isn't statistically significant enough to say there has been a change in the number of people smoking. But saying no change has been demonstrated statistically by its limited data is different to saying there has been no change.

Experts in smoking cessation say it's too early to know what the effect of plain packaging will be on young potential future smokers, but researchers have found it has had an effect on the number of existing smokers trying to quit.

Imperial Tobacco has told a British government inquiry it is too early to assess the impact of the Australian reforms.

ABS figures show tobacco consumption has been in decline for years.

The verdict

Mr Argent states "the data is clear" that tobacco consumption and smoking prevalence "has not gone down".

However, the data commissioned by Philip Morris is not clear. It is inconclusive. And there is contrary evidence emerging to suggest plain packaging has had an impact, and will contribute to a longer-term reduction in smoking rates.

Fast facts

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